Prepared and presented a case study on a pediatric patient with Tetralogy of Fallot.

1. Pediatric Case Study Jessica Schroeder Texas A & M University – Kingsville Dietetic Intern

2. Background Information

5. Baby CG’s Head Circumference- for-Age and Weight-for-Length Chart – 20 days (10/28/08) Vs. 4 months, 11 days (2/19/09) 20 days Ht: 50 cm Wt: 3.43 kg HC: 35.2 cm HC-for-Age: 10% Wt-for-Length: 50% 4 months, 11 days Ht: 65 cm Wt: 8.20 kg HC: 42 cm HC-for-Age: 50% Wt-for-Length: 90-95%

6. Baby CG’s Length-for-Age and Weight-for-Age Chart – 20 days (10/28/08) Vs. 4 months, 11 days (2/19/09) 20 days Ht: 50 cm Wt: 3.43 kg HC: 35.2 cm Length-for-Age: 10% Wt-for-Age: 10% 4 months, 11 days Ht: 65 cm Wt: 8.20 kg HC: 42 cm Length-for-Age: 75% Wt-for-Age: 90-95%

8. Baby CG’s Dx: Tetralogy of Fallot (TOF)

11. Tetralogy of Fallot (TOF)

12. Baby CG’s Abnormal Labs

13. Baby CG’s Abnormal ABG Labs at Birth 20 – L 21-28 mmol/L HCO3- 41 – L 80-105 mmHg pO2 40 32-45 mmHg pCO2 7.38 7.34-7.43 pH 10/8 Normal

15. Baby CG’s Abnormal Labs 2/18 – 2/22 34.5-H N/A N/A 35.3-H 36-H 32-34% MCHC 241 N/A 145-L 164 168 150-450 Platelets N/A N/A 43-H 39 38 2.0-40.0 U/L SGPT N/A N/A 92-H 132-H 133-H 2.0-40.0 U/L SGOT 9.9 9.2 9.3 9.6 12.6-H 8.5-10.5 mg/dL Serum Ca 92 106 202-H 185-H 286-H 30-125 mg/dL Glucose 98 99 106 111 - H 104 95-110 mmol/L Cl 2/22 2/21 2/20 2/19 2/18 Normal

18. Baby CG’s Labs after TOF Repair 0.8 0.2-L 0.4-1.5% Methemoglobin 93.3 - L 77.2-L 94.0-97.0% Oxyhemoglobin 16.2 - L 16.6-L 17.6-24.3% Oxygen content 37 43-H 27.0-42.0% HCT 12.5 14.5-H 9.0-13.5 gm/dL Total hemoglobin 63 - L 45-L 80-105 mmHg pO2 2/19 2/18 Normal

20. Baby CG’s Medications

24. Baby CG’s Pre-Op Medical Nutrition Therapy

29. Baby CG’s Surgeries and Procedures

32. Baby CG’s Pre-Op Medical Nutrition Therapy

37. THANK YOU!